The present study determined trends in malnutrition among under-5 children in urban and rural areas of Bangladesh.

Surveillance.

The study was conducted in the urban Dhaka and the rural Matlab hospitals of the International Centre for Diarrhoeal Disease Research, Bangladesh, where every fiftieth patient and all patients coming from the Health and Demographic Surveillance System were enrolled.

A total of 28 816 under-5 children were enrolled at Dhaka from 1993 to 2012 and 11 533 at Matlab between 2000 and 2012.

In Dhaka, 46 % of the children were underweight, 39 % were stunted and 28 % were wasted. In Matlab, the corresponding figures were 39 %, 31 % and 26 %, respectively. At Dhaka, 0·5 % of the children were overweight and obese when assessed by weight-for-age Z-score >+2·00, 1·4 % by BMI-for-age Z-score >+2·00 and 1·4 % by weight-for-height Z-score >+2·00; in Matlab the corresponding figures were 0·5 %, 1·4 % and 1·4 %, respectively. In Dhaka, the proportion of underweight, stunting and wasting decreased from 59 % to 28 % (a 53 % reduction), from 54 % to 22 % (59 % reduction) and from 33 % to 21 % (36 % reduction), respectively, between 1993 and 2012. In Matlab, these indicators decreased from 51 % to 27 % (a 47 % reduction), from 36 % to 25 % (31 % reduction) and from 34 % to 14 % (59 % reduction), respectively, from 2000 to 2012. On the other hand, the proportion of overweight (as assessed by BMI-for-age Z-score) increased significantly over the study period in both Dhaka (from 0·6 % to 2·6 %) and Matlab (from 0·8 % to 2·2 %).

The proportion of malnourished under-5 children has decreased gradually in both urban and rural Bangladesh; however, the reduction rates are not in line with meeting Millennium Development Goal 1. Trends for increasing childhood obesity have been noted during the study period as well.

To estimate the average annual rates of reduction of stunting, underweight and wasting for the period 1996 to 2011, and to evaluate whether Bangladesh will be expected to achieve the target of Millennium Development Goal 1C of reducing the prevalence of underweight by half by 2015.

We used five nationwide, cross-sectional, Demographic and Health Survey data sets to estimate prevalence of undernutrition defined by stunting, underweight and wasting among children under 5 years of age using the WHO child growth standards. We then computed the average annual rates of reduction of prevalence of undernutrition using the formula derived by UNICEF. Finally, we projected the prevalence of undernutrition for the year 2015 using the estimated average annual rates of reduction.

Nationwide covering Bangladesh.

Children under 5 years of age (n 28 941).

The prevalence of stunting decreased by 18·8 % (from 60·0 % to 41·2 %), underweight by 16·0 % (from 52·2 % to 36·2 %) and wasting by 5·1 % (from 20·6 % to 15·5 %) during 1996 to 2011. The overall average annual rates of reduction were 2·84 %, 2·69 % and 2·47 %, respectively, for stunting, underweight and wasting. We forecast that in 2015, the prevalence of stunting, underweight and wasting will be 36·7 %, 32·5 % and 14·0 %, respectively, at the national level. The prevalence of undernutrition is likely to remain high in rural areas, in the Sylhet division and in the poorest wealth quintile.

Bangladesh is likely to achieve the Millennium Development Goal 1C target of reducing the prevalence of underweight by half by 2015. However, it is falling behind in reducing stunting and further investment is needed to reduce individual, household and environmental determinants of stunting in Bangladesh.

Measurements of length at birth, or in the neonatal period, are challenging to obtain and often discounted for lack of validity. Hence, classical ‘under-5’ stunting rates have been derived from surveys on children from 6 to 59 months of age. Guatemala has a high prevalence of stunting (49·8 %), but the age of onset of growth failure is not clearly defined. The objective of the study was to assess length-for-age within the first 1·5 months of life among Guatemalan infants.

As part of a cross-sectional observational study, supine length was measured in young infants. Mothers’ height was measured. Length-for-age Z-scores (HAZ) were generated and stunting was defined as HAZ <−2 using WHO growth standards.

Eight rural, indigenous Mam-Mayan villages (n 200, 100 % of Mayan indigenous origin) and an urban clinic of Quetzaltenango (n 106, 27 % of Mayan indigenous origin), Guatemala.

Three hundred and six newborns with a median age of 19 d.

The median rural HAZ was −1·56 and prevalence of stunting was 38 %; the respective urban values were −1·41 and 25 %. Linear regression revealed no relationship between infant age and HAZ (r=0·101, r2=0·010, P=0·077). Maternal height explained 3 % of the variability in HAZ (r=0·171, r2=0·029, P=0·003).

Stunting must be carried over from in utero growth retardation in short-stature Guatemalan mothers. As linear growth failure in this setting begins in utero, its prevention must be linked to maternal care strategies during gestation, or even before. A focus on maternal nutrition and health in an intergenerational dimension is needed to reduce its prevalence.

To examine tracking of body size among children participating in the Norwegian Mother and Child Cohort Study (MoBa) from birth to 7 years of age and additionally to explore child and parental characteristics associated with maintenance of a high body size in this period of life.

Anthropometric data at birth and at 1, 3 and 7 years of age were collected by questionnaires addressed to the mother.

Participants were recruited from all over Norway during the period 1999–2008.

A total of 3771 children had complete anthropometric data at birth and at 1, 3 and 7 years of age; the sample includes children born between 2002 and 2004.

Cohen’s weighted kappa pointed to fair (0·36) to moderate (0·43) tracking of body size from birth to 7 years of age. Generalized estimating equations further indicated that children in the highest tertile of ponderal index at birth had nearly one unit higher BMI (kg/m2) at the age of 7 years compared with children in other tertiles of ponderal index at birth. Having parents with high BMI (≥25·0 kg/m2) increased the odds of having a stable high body size from birth to 7 years of age; moreover, girls had significantly higher odds compared with boys.

The study indicates fair to moderate tracking of body size from birth to 7 years of age. From a public health perspective, early prevention of childhood overweight and obesity seems to be especially important among children of parents having a high BMI.

Whether or not breast-feeding is protective against asthma among children is still controversial. Therefore, we examined the effects of breast-feeding on hospitalization for asthma in early childhood.

Secondary data analyses of a nationwide longitudinal survey of children in Japan ongoing since 2001, with results collected from 2001 to 2004. We used logistic regression models to evaluate the associations of breast-feeding with hospitalization for asthma in children between the ages of 6 and 42 months, adjusting for children’s factors (sex, day-care attendance and presence of older siblings) and maternal factors (educational attainment and smoking habit).

All over Japan.

Term singleton children with information on feeding practices during infancy (n 43367).

After adjusting for maternal factors and children’s factors, exclusive breast-feeding at 6–7 months of age was associated with decreased risk of hospitalization for asthma in children. The adjusted odds ratio was 0·77 (95 % CI 0·56, 1·06). One-month longer duration of breast-feeding was associated with a 4 % decreased risk of hospitalization for asthma (OR=0·96; 95 % CI 0·92, 0·99).

The protective effects of breast-feeding on hospitalization for asthma were observed in children between the ages of 6 and 42 months.

To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ).

Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included.

Philippines.

Infants (n 2822) measured bimonthly from 6 to 24 months.

Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0·246 (95 % CI 0·191, 0·302) sd longer and 0·523 (95 % CI 0·451, 0·594) sd heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast-fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns.

These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ.

The present study examined whether maternal diet and early infant feeding experiences relating to being breast-fed and complementary feeding influence the range of healthy foods consumed in later childhood.

Data from four European birth cohorts were studied. Healthy Plate Variety Score (HPVS) was calculated using FFQ. HPVS assesses the variety of healthy foods consumed within and across the five main food groups. The weighted numbers of servings consumed of each food group were summed; the maximum score was 5. Associations between infant feeding experiences, maternal diet and the HPVS were tested using generalized linear models and adjusted for appropriate confounders.

The British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de L’Enfant study (EDEN), the Portuguese Generation XXI Birth Cohort and the Greek EuroPrevall cohort.

Pre-school children and their mothers.

The mean HPVS for each of the cohorts ranged from 2·3 to 3·8, indicating that the majority of children were not eating a full variety of healthy foods. Never being breast-fed or being breast-fed for a short duration was associated with lower HPVS at 2, 3 and 4 years of age in all cohorts. There was no consistent association between the timing of complementary feeding and HPVS. Mother’s HPVS was strongly positively associated with child’s HPVS but did not greatly attenuate the relationship with breast-feeding duration.

Results suggest that being breast-fed for a short duration is associated with pre-school children eating a lower variety of healthy foods.

We conducted a cluster-randomized controlled trial to assess the efficacy of a cereal made from caterpillars, a micronutrient-rich, locally available alternative animal-source food, on reducing stunting and anaemia in infants in the Democratic Republic of Congo.

Six-month-old infants were cluster randomized to receive either caterpillar cereal daily until 18 months of age or the usual diet. At 18 months of age, anthropometric measurements and biological samples were collected.

The rural Equateur Province in the Democratic Republic of Congo.

One hundred and seventy-five infants followed from 6 to 18 months of age.

Stunting was common at 6 months (35 %) and the prevalence increased until 18 months (69 %). There was no difference in stunting prevalence at 18 months between the intervention and control groups (67 % v. 71 %, P=0·69). Infants in the cereal group had higher Hb concentration than infants in the control group (10·7 v. 10·1 g/dl, P=0·03) and fewer were anaemic (26 v. 50 %, P=0·006), although there was no difference in estimates of body Fe stores (6·7 v. 7·2 mg/kg body weight, P=0·44).

Supplementation of complementary foods with caterpillar cereal did not reduce the prevalence of stunting at 18 months of age. However, infants who consumed caterpillar cereal had higher Hb concentration and fewer were anaemic, suggesting that caterpillar cereal might have some beneficial effect. The high prevalence of stunting at 6 months and the lack of response to this micronutrient-rich supplement suggest that factors other than dietary deficiencies also contribute to stunting.

The study aimed to detail the lifestyle (physical activity and dietary habits) of Moroccan adolescents.

Cross-sectional study undertaken in the framework of the ATLS (Arab Teens Lifestyle Study).

Physical activity and dietary habits were determined using a validated questionnaire in public secondary schools.

A total of 669 adolescents aged 15·0–19·9 years were randomly recruited from Kenitra, Morocco.

Physical activity patterns and intensity differed between genders. As anticipated, male adolescents were more active than female adolescents across a typical week and engaged in more vigorous-intensity physical activity than female adolescents, who spent more time than male adolescents in moderate-intensity physical activity. Of particular concern was that one in five of the adolescents surveyed was inactive, with almost 45 % of the sample reporting television viewing for more than 2 h/d and 38 % engaged in computer use for a similar period. From a dietary perspective, most adolescents reported that they do not take breakfast or consume milk and dairy products, fruits and vegetables on a daily basis. In contrast, most reported consumption of doughnuts, cakes, candy and chocolate more than three times per week and approximately 50 % consumed sugary drinks more than three times per week.

Based on a continuation of the self-reported lifestyle behaviours, adolescents in the present study are at risk of developing chronic diseases. Education programmes are urgently needed to assist in the promotion of a healthy lifestyle and reduce the likelihood of overweight and obesity and related health risks among young people.

The Common Risk Factor Approach proposes that public health efforts can be improved by multiple agencies working together on a shared risk factor. The present study aimed to assess the acceptability to parents, dental practice staff and commissioners of the delivery of dietary advice in the dentistry setting in order to address obesity.

Semi-structured focus groups with dental practice staff and one-to-one interviews with parents of pre-school children and public health commissioners involved in an oral health promotion initiative delivering dietary advice in dental surgeries. Data were analysed using the Framework Approach.

General dental practice surgeries and pre-schools in areas of high deprivation in north-east England.

Parents (n 4), dental practice staff (n 23) and one commissioner.

All participants found acceptable the concept of delivering public health messages in non-conventional settings. Dental practice staff were concerned about the potential for conflicting messages and deprioritisation of oral health advice, and they identified practical barriers to delivery, such as lack of training. Parents were very apprehensive about the potential of such approaches to stigmatise overweight children, including bullying. Uncertainty over the causes of obesity led to confusion about its solutions and the roles of public health and health care.

Major concerns about the implementation of the Common Risk Factor Approach were raised by parents and dental practice staff. Specific dietary guidance for both oral health and healthy weight, as well as further research into issues of suitability, feasibility and stigmatisation, are needed.

To determine what factors are associated with parental motivation to change body weight in overweight children.

Cross-sectional study.

Dunedin, New Zealand.

Two hundred and seventy-one children aged 4–8 years, recruited in primary and secondary care, were identified as overweight (BMI≥85th percentile) after screening. Parents completed questionnaires on demographics; motivation to improve diet, physical activity and weight; perception and concern about weight; parenting; and social desirability, prior to being informed that their child was overweight. Additional measures of physical activity (accelerometry), dietary intake and child behaviour (questionnaire) were obtained after feedback.

Although all children were overweight, only 42 % of parents perceived their child to be so, with 36 % indicating any concern. Very few parents (n 25, 8 %) were actively trying to change the child’s weight. Greater motivation to change weight was observed for girls compared with boys (P=0·001), despite no sex difference in BMI Z-score (P=0·374). Motivation was not associated with most demographic variables, social desirability, dietary intake, parenting or child behaviour. Increased motivation to change the child’s weight was observed for heavier children (P<0·001), those who were less physically active (P=0·002) and more sedentary (P<0·001), and in parents who were more concerned about their child’s weight (P<0·001) or who used greater food restriction (P<0·001).

Low levels of parental motivation to change overweight in young children highlight the urgent need to determine how best to improve motivation to initiate change.

The aim of the present study was to gain insight into (i) processed snack-food availability, (ii) processed snack-food salience and (iii) the size of dinnerware among households with overweight gatekeepers. Moreover, associations between gatekeepers’ characteristics and in-home observations were determined.

A cross-sectional observation of home food environments was conducted as part of a baseline measurement of a larger study.

Home food environments of overweight and obese gatekeepers in the Netherlands.

Household gatekeepers (n 278). Mean household size of the gatekeepers was 3·0 (sd 1·3) persons. Mean age of the gatekeepers was 45·7 (sd 9·2) years, 34·9 % were overweight and 65·1 % were obese. Of the gatekeepers, 20·9 % had a low level of education and 42·7 % had a high level of education.

In 70 % of the households, eight or more packages of processed snack foods were present. In 54 % of the households, processed snack foods were stored close to non-processed food items and in 78 % of households close to non-food items. In 33 % of the households, processed snack foods were visible in the kitchen and in 15 % of the households processed snack foods were visible in the living room. Of the dinnerware items, 14 % (plates), 57 % (glasses), 78 % (dessert bowls), 67 % (soup bowls) and 58 % (mugs) were larger than the reference norms of the Netherlands Nutrition Centre Foundation. Older gatekeepers used significantly smaller dinnerware than younger gatekeepers.

Environmental factors endorsing overconsumption are commonly present in the home environments of overweight people and could lead to unplanned eating or passive overconsumption.

Adequate Zn and Mg intakes may be beneficial for the prevention and treatment of mental health problems, such as depression, anxiety and attention-deficit hyperactivity disorder. We aimed to investigate the prospective association between dietary intakes of Zn and Mg and internalising and externalising behaviour problems in a population-based cohort of adolescents.

Prospective analysis (general linear mixed models) of dietary intakes of Zn and Mg assessed using a validated FFQ and mental health symptoms assessed using the Youth Self-Report (YSR), adjusting for sex, physical activity, family income, supplement status, dietary misreporting, BMI, family functioning and energy intake.

Western Australian Pregnancy Cohort (Raine) Study.

Adolescents (n 684) at the 14- and 17-year follow-ups.

Higher dietary intake of Mg (per sd increase) was significantly associated with reduced externalising behaviours (β=−1·45; 95 % CI −2·40, −0·50; P=0·003). There was a trend towards reduced externalising behaviours with higher Zn intake (per sd increase; β=−0·73; 95 % CI −1·57, 0·10; P=0·085).

The study shows an association between higher dietary Mg intake and reduced externalising behaviour problems in adolescents. We observed a similar trend, although not statistically significant, for Zn intake. Randomised controlled trials are necessary to determine any benefit of micronutrient supplementation in the prevention and treatment of mental health problems in adolescents.

To examine the association of total animal protein intake and protein derived from different dietary sources (meat; fish and shellfish; eggs; milk products) with global and abdominal obesity among adults in Luxembourg.

Binary logistic regression analysis was used to assess the relationship between animal protein intake (as a percentage of total energy intake) and global obesity (BMI≥30·0 kg/m2) and abdominal obesity (waist circumference ≥102 cm for men and ≥88 cm for women), after controlling for potential confounders.

Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study.

The study population was derived from a national cross-sectional stratified sample of 1152 individuals aged 18–69 years, recruited between November 2007 and January 2009.

There was an independent positive association between total animal protein intake and both global (OR=1·18; 95 % CI 1·12, 1·25) and abdominal obesity (OR=1·14; 95 % CI 1·08, 1·20) after adjustment for age, gender, education, smoking, physical activity and intakes of total fat, carbohydrate, fibre, and fruit and vegetables. Protein intakes from meat, fish and shellfish were positively associated with global and abdominal obesity with further adjustment for vegetal protein and other sources of animal-derived protein (all P<0·01). Protein derived from eggs or milk products was unrelated to global or abdominal obesity.

Our findings suggest that protein derived from animal sources, in particular from meat, fish and shellfish, may be associated with increased risk of both global and abdominal obesity among presumably healthy adults in Luxembourg. These findings suggest that lower animal protein intakes may be important for maintenance of healthy body weight.

The present study investigates the relationship between BMI and all-cause mortality among middle-aged and older adults with or without pre-existing diseases.

A population-based cohort study.

The Taiwan Longitudinal Study on Aging is a nationwide prospective cohort study comprising a representative random sample of middle-aged and older adults. The study period was 1996–2007.

We followed 4145 middle-aged and older adults, totalling 42 353 person-years.

Overweight and mildly obese participants showed a 16 % and 30 % decrease in the risk of death, respectively, compared with those of normal weight after adjusting for potential covariates (e.g. demographic characteristics, health behaviour, co-morbidities and physical function). Underweight adults showed a 1·36-fold increased adjusted hazard ratio of death compared with normal-weight adults. Adults with a BMI of 27·0–28·0 kg/m2 showed a significantly lower adjusted hazard ratio of all-cause mortality rate compared with adults who had normal BMI values when they had coexisting hypertension or diabetes (adjusted hazard ratio=0·50; 95 % CI 0·30, 0·81 for hypertension and adjusted hazard ratio=0·41; 95 % CI 0·18, 0·89 for diabetes).

The study demonstrates that underweight people have a higher risk of death, and overweight and mildly obese people have a lower risk of death, compared with people of normal weight among middle-aged and older adults. An optimal BMI may be based on the individual, who exhibits pre-existing diseases or not.

To review the literature on bisphenol A (BPA) exposure and obesity in human populations.

Systematic review of the literature via searches of PubMed, EMBASE, Web of Science and reference lists for articles published to 1 August 2014.

China, Italy, Japan, Republic of Korea, Sweden, UK, USA.

Adults (≥18 years).

Eighteen articles were identified and included in the review. Twelve studies included secondary evaluations of BPA exposure and BMI, and six studies evaluated body composition as the primary outcome. All analyses were cross-sectional and no study included in the review received a positive quality rating (twelve negative, six neutral). Eight studies observed a statistically significant positive association between urinary or serum BPA levels and BMI, and ten studies observed no association. Studies where BMI was a primary outcome and studies of neutral quality were more likely to observe an association.

Study results are conflicting and significant methodological issues limit the ability to draw conclusions from these studies. Prospective studies that measure BPA exposure and changes in body weight and composition are needed to establish temporality, causality and the direction of any observed associations.

To explore public health nutritionists’ perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition.

Qualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation.

Queensland, Australia.

Public health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience.

Opportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners’ perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes.

Public health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are ‘for the good’ of mothers and infants.

To understand and compare the primary barriers households face when accessing treatment for cases of childhood severe acute malnutrition (SAM) in different cultural settings with different types of implementing agencies.

The study presents a comparative qualitative analysis of two SAM treatment services, selected to include: (i) one programme implemented by a non-governmental organization and one by a Ministry of Health; and (ii) programmes considered to be successful, defined as either coverage level achieved or extent of integration within government infrastructure. Results from individual interviews and group discussions were recorded and analysed for themes in barriers to access.

Sindh Province, Pakistan; Tigray Region, Ethiopia.

Beneficiary communities and staff of SAM treatment services in two countries.

Common barriers were related to distance, high opportunity costs, knowledge of services, knowledge of malnutrition and child’s refusal of ready-to-use foods. While community sensitization mechanisms were generally strong in these well-performing programmes, in remote areas with less programme exposure, beneficiaries experienced barriers to remaining in the programme until their children recovered.

Households experienced a number of barriers when accessing SAM treatment services. Integration of SAM treatment with other community-based interventions, as the UN recommends, can improve access to life-saving services. Efforts to integrate SAM treatment into national health systems should not neglect the community component of health systems and dedicated funding for the community component is needed to ensure access. Further research and policy efforts should investigate feasible mechanisms to effectively reduce barriers to access and ensure equitable service delivery.

The objective of the present study was to describe changes in overweight and obesity prevalence and eating habits among 7·5–10·5-year-old children in Aquitaine (France) between 2004 and 2008, and to assess how the programme ‘Nutrition, Prevention and Health of children and teenagers in Aquitaine’ implemented in 2004 may have impacted these changes.

Two cross-sectional studies were conducted in two samples of children: the ‘before programme’ sample during the school year 2004/2005 and the ‘after programme’ sample during the school year 2008/2009.

Data were collected on gender, age, weight, height, area of residence (rural/urban) and socio-economic status of the school (non-low socio-economic/low socio-economic). Multivariate analyses were used to assess the effect of the regional programme intervention on the evolution of overweight and obesity prevalence and eating habits independently.

The ‘before programme’ sample included 1836 children from 163 schools during the school year 2004/2005 and the ‘after programme’ sample included 3483 children from 210 schools during the school year 2008/2009.

After adjustment of the model for age, residential area and socio-economic status of the area of residence, the prevalence of overweight including obesity (OR=1·05; 95 % CI 0·89, 1·23, P=0·56) and of obesity (OR=0·99; 95 % CI 0·71, 1·39, P=0·96) was found to have stabilized and eating habits had improved: intake of light afternoon meals had increased (OR=1·38; 95 % CI 1·13, 1·69, P=0·002) while snacking in the morning (OR=0·50; 95 % CI 0·45, 0·57, P<0·001) and nibbling (OR=0·81; 95 % CI 0·70, 0·93, P<0·001) had decreased.

These results encourage the promotion and implementation of regional and national interventions among children regarding their eating habits in order to stabilize or decrease the prevalence of overweight.